학술논문
Real-world safety and efficacy data of immunotherapy in patients with cancer and autoimmune disease: the experience of the Hellenic Cooperative Oncology Group
Document Type
Original Paper
Author
Fountzilas, Elena; Lampaki, Sofia; Koliou, Georgia-Angeliki; Koumarianou, Anna; Levva, Sofia; Vagionas, Anastasios; Christopoulou, Athina; Laloysis, Athanasios; Psyrri, Amanda; Binas, Ioannis; Mountzios, Giannis; Kentepozidis, Nikolaos; Kotsakis, Athanassios; Saloustros, Emmanouil; Boutis, Anastasios; Nikolaidi, Adamantia; Fountzilas, George; Georgoulias, Vassilis; Chrysanthidis, Miltiadis; Kotteas, Elias; Vo, Henry; Tsiatas, Marinos; Res, Eleni; Linardou, Helena; Daoussis, Dimitrios; Bompolaki, Iliada; Andreadou, Anna; Papaxoinis, George; Spyratos, Dionisios; Gogas, Helen; Syrigos, Konstantinos N.; Bafaloukos, Dimitrios
Source
Cancer Immunology, Immunotherapy. 71(2):327-337
Subject
Language
English
ISSN
0340-7004
1432-0851
1432-0851
Abstract
Background: Data on the safety and efficacy of immune checkpoint inhibitors (ICI) in patients with concurrent autoimmune diseases (AID) are limited.Methods: We performed a retrospective multicenter review of medical records of patients with cancer and underlying AID who received ICI. The primary endpoint was progression-free survival (PFS).Results: Among 123 patients with pre-existing AID who received ICI, the majority had been diagnosed with non-small cell lung cancer (NSCLC, 68.3%) and melanoma (14.6%). Most patients had a rheumatologic (43.9%), or an endocrine disorder (21.1%). Overall, 74 (60.2%) patients experienced an immune-related adverse event (irAE) after ICI initiation, AID flare (25.2%), or new irAE (35%). Frequent irAEs included thyroiditis, dermatitis and colitis. ICI was permanently discontinued due to unacceptable (8.1%) or fatal (0.8%) toxicity. In patients with NSCLC, corticosteroid treatment at the initiation of immunotherapy was associated with poor PFS (HR = 2.78, 95% CI 1.40–5.50, p = 0.003). The occurrence of irAE was associated with increased PFS (HR = 0.48, 95% CI 0.25–0.92, p = 0.026). Both parameters maintained their independent prognostic significance.Conclusions: ICI in patients with cancer and pre-existing AID is associated with manageable toxicity that infrequently requires treatment discontinuation. However, since severe AID flare might occur, expected ICI efficacy and toxicity must be balanced.Clinical trial identifier: NCT04805099